Bartsocas-Papas syndrome in an Arab family with four affected sibs: further characterization.

Bartsocas-Papas syndrome is a severe autosomal recessive popliteal pterygium syndrome. Other anomalies include microcephaly, facial clefts, filiform bands, ankyloblepharon, syndactyly, and other ectodermal and nonectodermal anomalies. We report on four Arab sibs with manifestations of this syndrome and some additional traits that include cutis aplasia, widely spaced nipples, low-set umbilicus, and unilateral renal hypoplasia among others. One was stillborn, and the other three children lived 10-17 months. Parents were nonconsanguineous, derived from different Bedouin tribes in Qatar and the United Arab Emirates. Similar cases from the literature are reviewed.

Effects of some trace elements on platelet function in rats.

The present study portrays the effects of some elements, namely: iron, zinc, copper, magnesium and gold, on platelet count, PCV and platelet aggregation, 60 minutes following administration of the metal salts. Marked thrombocytopenia was encountered in rats treated with ferrous sulphate while the platelet count was significantly changed with the other elements tested. The PCV was significantly increased following treatment with ferrous sulphate and large dose of gold chloride, but was insignificantly altered with the other elements. As regards platelet aggregation, all metals tested, with the exception of magnesium caused significant inhibition of platelet aggregation was only significantly impaired following treatment with iron and gold, but was insignificantly altered following treatment with zinc and copper. On the other hand, treatment with magnesium resulted in enhancement of both ADP- and collagen-induced aggregation. The mechanisms underlying these effects are discussed.

In vitro effects of trace elements on blood clotting and platelet function. A--Iron, copper, and gold.

The present in vitro study of the effects of iron on the blood coagulation mechanism in rats showed that addition of ferrous sulphate to pooled rat plasma resulted in inhibition of blood coagulation, as shown by prolongation of the clotting parameters tested, an effect which was dose-dependent. In vitro addition of ferrous sulphate to rat PRP in doses of 2-5 mg/ml significantly decreased platelet aggregation in response to ADP, while collagen-induced aggregation was significantly diminished in presence of the higher doses of ferrous sulphate (4-5 mg/ml). Also, preincubation of ferrous sulphate with thrombin or with pure fibrinogen indicated that iron could produce decrease of thrombin activity as well as impairment of fibrinogen clottability. In vitro addition of copper sulphate (300-1000 micrograms/ml) elicited an anticoagulant effect, though thrombin time was markedly shortened with all tested concentrations of copper sulphate. Addition of copper sulphate to PRP produced inhibition of platelet aggregation in response to PRP produced inhibition of platelet aggregation in response to ADP and to collagen. Preincubation of copper sulphate with thrombin resulted in slight enhancement of thrombin activity followed by inhibition, while preincubation of copper sulphate with pure fibrinogen caused only minimal impairment of fibrinogen clottability. Also, addition of gold chloride in doses of 50-500 micrograms/ml to plasma in vitro produced a dose-dependent progressive prolongation of all clotting parameters tested, the effects reaching a maximum after 30 min. incubation. Further the in vitro addition of gold chloride to rat PRP resulted in marked inhibition of platelet aggregation in response to both ADP and collagen. In addition, preincubation of gold chloride with thrombin or with pure fibrinogen showed that gold exerted an antithrombin action and prolonged the fibrinogen clotting time indicating impaired fibrinogen clottability.

In vitro effects of trace elements on blood clotting and platelet function. B--Zinc and magnesium.

The in vitro effects of zinc and magnesium salts on blood coagulation mechanism and platelet aggregation were studied on rat plasma. Addition of zinc sulphate to pooled rat plasma in a range of concentrations (0.3-1 mg/ml) caused a dose dependent significant prolongation of recalcification, prothrombin and partial thromboplastin times. These effects reached a peak after 30 minutes while the thrombin clotting time was not significantly altered and was even shortened in the presence of highest concentration of zinc tested (1 mg/ml). Incubation of thrombin with zinc sulphate (150 micrograms/ml) for up to 30 minutes did not affect significantly the action of thrombin. Incubation of the same concentrations of zinc sulphate with fibrinogen produced non clotting of fibrinogen after 0-minutes. Addition of rising concentrations of zinc sulphate to rat PRP produced inhibition of ADP-induced platelet aggregation. On the other hand, collagen-induced aggregation was insignificantly inhibited in the presence of zinc. In contrast, in vitro additions of rising concentrations of magnesium sulphate (2-5 mg/ml) to pooled rat plasma exerted no effect on recalcification time immediately after addition (0-minutes), but after 5 minutes following incubation it produced significant shortening of recalcification time in all the doses tested. The prothrombin time showed a general trend of shortening, maximal after 5-minutes incubation. The results of partial thromboplastin times revealed clotting before addition of calcium chloride. The thromboplastin time also showed progressive shortening with rising concentrations of magnesium sulphate. When thrombin solution was exposed to magnesium sulphate (2.5 mg/ml) no effect on the activity of thrombin was seen for up to 30 minutes. Fibrinogen solution similarly exposed to the same concentration of magnesium sulphate did not show any significant effect on its clottability with thrombin for up to 30 minutes. Magnesium sulphate in the range of doses tested significantly enhanced platelet aggregation of PRP in response to both ADP and collagen, and the responses observed were not dose dependent. The mechanisms underlying the effects of these two metals on blood clotting and platelet aggregation are discussed.

Study of the risk factors for viral hepatitis C infection among Egyptians applying for work abroad.

The aim of this study was to identify the risk factors for viral hepatitis C infection among Egyptians. A cross-sectional study with case-control analysis was conducted including 5071 Egyptians applying to the Ministry of Health Laboratories for certification of freedom from viral hepatitis (B and C) to work abroad. A questionnaire designed to cover the most important known and suspected risk factors was filled out by physicians interviewers before blood drawing and after proper orientation of the purpose of the study. The overall seropositivity among the whole sample for HCV was 31.5% and was significantly lower among females (13.2%) than among males (34%). A consistent increase of seropositivity for HCV antibodies with age (in males and females and in urban and rural areas) was observed with a peak level of 54.9% in all individuals for the age group 45-49 years (significant trend p < 0.0001). A significant increase of seropositivity (p < 0.005) above 25 years of age (35.7%) than below this age 12.8%) was observed on examination of HCV distribution in 5-year age group. Married individuals have a significant higher seropositivity for HCV than non-married (38.2% and 20.9% respectively OR = 2.3, 95% CL 2.1-2.7). Individuals living in rural areas had significantly more HCV seropositivity than those living in urban areas (OR = 1.7, 95% CL 1.5-2.0). Also, individuals living in Cairo and seashore governorates had significantly lower seropositivity (14.7% and 12.7% respectively) than those living in governorates in upper or lower Egypt (29.4% and 36.3% respectively). Medical procedures risk factors identified to be associated with significant higher HCV seropositivity included: past history of injections for bilharziasis, use of common syringes, dental extraction, injections for urography, blood transfusions and previous hospitalizations. Multivariate logistic analysis revealed that only age, male sex, marriage, rural residence, living in upper and lower Egypt, injections for bilharziasis and urography were significant in the final equation for the whole group. Blood transfusion was significant in the final regression analysis among females in urban living and hospitalization was significant among males in urban living and females in rural living. Further research is needed to elucidate those factors prevailing in rural areas and in upper and lower Egypt associated with increased risk for HCV infection.

Assessment of efficacy of praziquantel against Schistosoma mansoni infection.

In order to assess the efficacy of praziquantel against Schistosoma mansoni infection, a clinical trial was carried out in Namool village in patients with different intensities of infection according to the geometric mean egg count. Different doses were given (20, 30, 40 mg/kg body weight). A parasitological follow-up was carried out after 1 and 6 months from treatment. The percentage of cure was high and reached 89.4% among the low-egg-count group who received 40 mg/kg body weight. A high percentage of reduction was noted in the mean egg count of the non-cured cases which reached 92.6% in the high-egg-count group who received 40 mg/kg body weight of praziquantel. Mild side effects increased in frequency as dosage increased, abdominal disturbance, vomiting and fever. Praziquantel seems to be an ideal drug against Schistosoma mansoni infection especially for mass treatment as it is given in a single oral dose.

Usage of personal protective devices among Egyptian industrial workers.

A systematic random sample of 405 workers from metal, asbestos cement pipes, textile, and viscose rayon industries were interviewed using a prepared and tested questionnaire. Personal Protective Devices (PPDs), namely goggles, gloves, respirators, and ear defenders, had been distributed to all workers on the payroll and were used by 31.4%. Usage of PPDs was associated with the educational level, duration of occupation, awareness of the work hazards, and knowledge about the purpose of PPDs. Marked association was found between nonusage of PPDs and discomfort, interference with job performance, and the psychological feeling of lowering the person's prestige by the wearing of PPDs. Nonusage was also associated with lack of maintenance of the device and absence of supervision of its usage. Users were more numerous among married workers and workers with urban residence than among unmarried workers and those with rural residence, respectively. No association could be found between the rate of usage and the worker's age except for ear plugs, for which nonusage was proportional to the worker's age. The most important factors were those related to the role of the safety staff and the discomfort of the devices. Recommendations for occupational health authorities on the basis of the above evaluation are suggested.

Effect of carbon-disulfide intoxication on the levels of serum copper and ceruloplasmin.

Under the effect of carbon-disulphide intoxication on the experimental animals, a significant decrease in serum copper and ceruloplasmin levels was observed. The decrease was aggravated with prolongation of carbon disulphide intoxication due to loss of appetite, formation of chelating compounds with carbon disulphide metabolites and increased loss of copper in urine. However, reinvestigated at 20 days after stoppage of dosage, most of these derangements started to be alleviated.

Serum and urine amino acid pattern under the effect of carbon disulfide intoxication.

The effect of carbon disulphide intoxication on amino acid pattern was studied. Five groups of rats were treated with carbon disulphide through intramuscular injection of 0.05 ml CS2 in 0.2 mg olive oil/rat/day. A number of rats were sacrificed after receiving 10, 20, 30, 40, and 50 injections. As a result of intoxication, a state of hypoaminoacidemia and hyperaminoacidurea affected all the amino acids investigated, but to variable extent. Of value to add that stoppage of carbon disulphide leads to improvement of the amino-acid pattern in group six, compared to the other groups.

Schistosoma mansoni egg specific antibodies and circulating antigens: assessment of their validity in immunodiagnosis of schistosomiasis.

A total of 127 individuals of different age and sex; 92 from Kafr-Sendewa, Qualyobia Governorate, Egypt, in comparison to 23 cases with hydatidosis and fascioliasis as a parasitic control group, and 12 healthy control group from non-endemic area. All cases were screened by clinical examination, urine, stool, rectal snip, abdominal ultrasonographic examination and indirect haemagglutination test (IHAT). Accordingly, they were grouped into active intestinal schistosomiasis group, seropositive group by (IHAT), normal control group from the same endemic area, parasitic control group and normal control group. All cases were subjected to detection of IgG, IgM, IgG4, anti-soluble egg antigen (SEA) and anti-excretory-secretory egg antigen (ESEA) by ELISA tests; and circulating egg antigens by double-sandwich ELISA techniques. The results showed that IgG4 anti-SEA is the best diagnostic test, as it gave the best diagnostic efficacy (90%). Also, it is a good screening test which can be used in endemic area as it gave significant difference between the active intestinal schistosomiasis cases with each of the endemic control group (P < 0.001) and the seropositive cases (P < 0.05). Other valid diagnostic egg specific antibodies tests were IgM anti-SEA and IgG anti-SEA as their diagnostic efficacy were 80% and 76.6% respectively (P < 0.05). The diagnostic efficacy of circulating antigen detection (C.Ag) test was 70% (P < 0.05). In addition, it was the most specific test with 100% specificity. IG4-anti-ESEA gave the least cross-reaction with other parasites (17.3%). The mean optical density (OD) level of circulating antigen detection test was significantly higher in the organomegalic (hepatosplenomegaly) cases than the non-organomegalic cases (P < 0.05).